Ranking facial attractiveness.

The first aim of this investigation was to assemble a group of photographs of 30 male and 30 female faces representing a standardized spectrum of facial attractiveness, against which orthognathic treatment outcomes could be compared. The second aim was to investigate the influence of the relationship between ANB differences and anterior lower face height (ALFH) percentages on facial attractiveness. The initial sample comprised standardized photographs of 41 female and 35 male Caucasian subjects. From these, the photographs of two groups of 30 male and 30 female subjects were compiled. A panel of six clinicians and six non-clinicians ranked the photographs. The results showed there to be a good level of reliability for each assessor when ranking the photographs on two occasions, particularly for the clinicians (female subjects r = 0.76-0.97, male subjects r = 0.72-0.94). Agreement among individuals within each group was also high, particularly when ranking facial attractiveness in male subjects (female subjects r = 0.57-0.84, male subjects r = 0.91-0.94). Antero-posterior (AP) discrepancies, as measured by soft tissue ANB, showed minimal correlation with facial attractiveness. However, a trend emerged that would suggest that in faces where the ANB varies widely from 5 degrees, the face is considered less attractive. The ALFH percentage also showed minimal correlation with facial attractiveness. However, there was a trend that suggested that greater ALFH percentages are considered less attractive in female faces, while in males the opposite trend was seen. Either of the two series of ranked photographs as judged by clinicians and non-clinicians could be used as a standard against which facial attractiveness could be assessed, as both were in total agreement about the most attractive faces. However, to judge the outcome of orthognathic treatment, the series of ranked photographs produced by the non-clinician group should be used as the 'standard' to reflect lay opinion.